Dexmeditomedine Vs Morphine infusion for sedation in mechanically ventilated Term Neonates

Newborn babies require intensive care for various reasons**.**Mechanical ventilation is one of the modes of treatment. It is associated with pain and hence agitation resulting in ventilation dysynchrony. Pain can have impact on the vital parameters and also can have long term morbidities. Hence, Pain relief and in some cases, sedation is necessary to optimize care for critically ill babies and also to facilitate gas exchange. Opioids such as morphine or fentanyl are the commonly used pain relief and sedation as first line in neonatal intensive care units.

However, these drugs can result in substantial respiratory depression, decreased gastrointestinal motility and hypotension due to vasodilatation. All these effects are seen even at lower therapeutic doses. These adverse effects may lead to prolonged duration of ventilation, hospital stay and eventually increased morbidity. Hence, there a need for a newer drug to have a fine balance between achieving comfort without much of side effect.

Dexmeditomedine is a centrally active alpha receptor agonist having both sedative and analgesic properties. There is evidence to suggest that dexmeditomedine has lesser respiratory depression, no GI side effects and also promotes macrophage activity thereby reducing the sepsis.

This study was aimed at comparing the Dexmeditomedine infusion with morphine for sedation and pain relief in term ventilated babies.